Auditory Processing is the ability to make sense of the information we hear. It includes our ability to understand spoken instructions, and to remember several step instructions, such as "put the milk in the fridge and then bring me your homework."
The Auditory System is the system that takes in and processes sound information. This includes the ability to hear as well as the ability to make sense of what you hear (see Auditory Processing).
The word Autism is a little deceiving. It should ideally be: Autistic Spectrum Disorder. This describes a collection of difficulties faced by children. No two children with Autistic Spectrum Disorder will behave in the same way, although there may be many similarities. This is a pervasive developmental disorder, where children will have difficulty with social development, language, behaviour and sensory processing. Children with Autistic Spectrum Disorder can be functioning anywhere between very low functioning to high functioning and will have a variety of different behavioural mannerisms, sensory difficulties and language and social difficulties. Some children with Autism will be able to cope independently in mainstream school, some will cope in mainstream school with assistance, and some may need specialized schooling. Children on the Autistic Spectrum would benefit from being under the regular supervision of psychologists, speech and language therapists, occupational therapists and physiotherapists. This will ensure that all areas of their development are monitored and promoted effectively.
The ability to maintain an upright posture under varying conditions. Although the most obvious activities which require balance are things like walking, jumping and riding a bicycle, almost all activities that we do require our ability to maintain our body position in space. For example, while sitting at a desk, we need to stretch to the far corner of the desk for our pencil without falling over, or we need to stand in a line outside a classroom while other children are bumping and pushing us without falling over. Good balance depends on many factors, the most obvious is the vestibular apparatus in our ears. It also depends on the appropriate development of reflexes, such as equilibrium reactions, good muscle tone and good motor planning.
This is the ability to use the two sides of the body together in a coordinated manner. Since the left side of the brain controls the movement of the right side of the body, and the right side of the brain controls the movement of the left side of the body, the two sides of the brain need to work and move together in order to manage tasks that rely on both sides of the body. These tasks include cutting, skipping along, riding a bicycle, opening bottles, fastening buttons, eating with a knife and fork, etc.
There are several types of bilateral movements, and they develop in a particular sequence. Firstly, is the ability to use the two sides of the body together doing exactly the same task, e.g. holding a bottle with two hands. Next, the child learns to use 1 hand to stabilize (usually the non-dominant hand) while the other hand is functional, e.g. holding the page still with the left hand while colouring with the right hand. Then the child learns to use each side functionally, at the same time, e.g. pedaling a bicycle.
Body concept is the understanding of the body and it's structure, i.e. that we have a left arm and a right arm, 10 fingers etc. This is essential for developing the ability to interpret the information received from the sensory systems in relation to the body and thereby to learn to use that body in a coordinated manner. Immature Body Concept will affect a child's ability to understand his or her body. This affects understanding of left and right, and negatively impacts on motor planning and movement in general.
This is the understanding of an object's position in space in relation to yourself. This is important for the discrimination of letters and numbers for reading and writing.
Dyspraxia is difficulty planning motor movements. Praxis is the process of planning movements. It is comprised of many steps. First, we have to picture in our minds what it is we want to do (e.g. ride a bicycle), then plan how we are going to do it (move first the right leg in a forward circular pattern, then the left leg), then we do it. This process can sometimes get a little confusing for some children, who can have difficulty with any of these areas. This results in dyspraxia. Dyspraxia is difficulty planning new or unfamiliar movements. The process of walking or running is not (after the first few years of life) planned. We do these things automatically, but learning to ride a bicycle, learning to drive a car or learning to do Irish Dancing all require planning.
It is very important to differentiate between dyspraxia (planning movements) and coordination (doing the movement smoothly). Although this often gets confused, dyspraxia is not poor coordination, and likewise, poor coordination is not dyspraxia. It is possible for a child to have poor coordination but to have no difficulty planning unfamiliar movements. Likewise, it is possible for a child to have dyspraxia, but to have normal coordination. However, it is also possible for a child with dyspraxia to have poor coordination as well.
ATLAS Training has many clients with dyspraxia, therefore we have devoted a whole section to this condition, you can find more information here
Ocular pursuits are the eye’s ability to follow/track objects as they move. Dissociation (of the head and eye movements) allows the eyes to move to follow objects while the head remains still.
Poor eye movements will impact on the child’s ability to follow text across a page and to copy work off an overhead or blackboard. It will also negatively impact on ball skills and hand-eye coordination.
These are motor skills involving fine or small body movements. They include threading, doing buttons, writing, colouring, cutting, crafts, etc. They rely on many factors, including muscle tone,reflex integrationand motor planning.
These are motor skills involving large body movements. They include walking, running, jumping, hopping, climbing, ball skills, etc. Motor skills rely on many factors, including muscle tone, balance, reflex integration, coordination, motor planning etc.
This is the system that involves the sense of taste. It involves understanding what is being eaten, as well as tolerating it. Some children will use an excessive amount of seasoning, such as ketchup to disguise the taste of food. Some may be overly sensitive to the taste of everyday items, such as toothpaste. It is possible that some children cannot tolerate certain tastes and this can result in temper tantrums, crying or even gagging. Sometimes, however, this can commonly be caused by the texture of the food, rather than the taste, and this is a tactile defensiveness.
The ability to regulate and change our state of alertness is a fundamental skill that is necessary for all activities, from paying attention in the classroom, to falling asleep at night. Children (and adults) who have difficulty regulating their level of alertness frequently have an modulation disorder, and tend to have any of the following symptoms: difficulty falling or staying asleep, difficulty controlling emotions, difficulty dealing with frustrations, difficulty paying attention or difficulty initiating and completing tasks (note: modulation difficulties can be caused by many different factors,Sensory Processing Disorder being only one of these).
Praxis (Motor Planning) is a learnt ability to plan and direct a series of coordinated movements towards achieving a result. Praxis is most required when a new skill is being learnt or an unusual series of movements is required.
Poor motor planning leads to difficulty with writing and the ability to learn new skills (sports, cycling, driving etc).
For more details, see 'Dyspraxia'
Muscle tone is the tone (or tension) in the muscle when that muscle is not under conscious control. Normal muscle tone allows us to stand/sit upright without falling, and prepares us for action.
This is the system that involves the sense of smell. It involves both the ability to smell, as well as the ability to understand what is being smelt. Children who have 'Olfactory Defensiveness' may remove themselves from areas of strong smells, such as the soap isle in a shop, or may make inappropriate comments to others, such as "You smell bad"
Reflexes are the body’s natural way of preparing us for learning and protecting us from harm, for example putting your arm out to catch yourself when you fall. Reflexes appear and disappear at different times in the maturation of the nervous system and are therefore important indicators of the development of that nervous system. Many reflexes are present at birth and are later integrated into normal movement. Others develop slightly later on in infancy or childhood and some remain throughout life.
Postural control is the body’s ability to undertake normal movements, such as standing up, walking running etc. It is dependent on many factors, especially muscle tone, reflex integration, bilateral integration, balance etc.
Proprioception is the body’s awareness of its own position in space, without relying on visual input. Proprioception relies on nerves in the joints and muscles as well as on the vestibular system (see below) for information about body position. This is the system that tells us what we are doing with our bodies (i.e. stretching our arm out to hit a tennis ball) and how hard we are doing it (i.e. hard enough to get the ball to the other side of the court, but not so hard that it goes 'out').
Children who have a poorly integrated proprioceptive system are likely to appear clumsy, may break toys frequently, may press too hard or too softly when writing, etc. Some children seek proprioceptive stimulation in order to understand their environment a bit better. These children are likely to partake frequently in rough and tumble games and to enjoy activities that involve movement and crashing/bumping.
Sensory Integration is the term that was previously used for what we now term Sensory Processing. This is the neurological process that organizes sensation from one's own body and the environment and makes in possible to use that body effectively with the environment (A. Jean Ayers, PhD).
This is a condition which occurs when a child has difficulty 'making sense' of the information they receive through their sensory system about the world around them. Sensory Processing (otherwise known as Sensory Integration) is the neurological process that organizes sensation from one's own body and the environment and makes in possible to use that body effectively with the environment (A. Jean Ayers, PhD).
Speech and/or language can be delayed or impaired for a variety of reasons. In some cases, there doesn’t appear to be any cause that we can find, and in other cases the causes are more clear. For Specific Disorders, see below.
Difficulty with forming speech sounds characterised by either omitting, distorting, substituting or adding sounds. Articulation errors may be developmental, it becomes a disorder when the errors continue after a certain developmental age of speech sound acquisition.
As the name states Auditory Processing Disorder (APD) is a difficulty with processing and interpreting the auditory information taken in from our environment. It does not come from a hearing impairment, since it has to do with processing of heard information rather than the actual physical hearing of sound information.
Children with APD have difficulties with:
hearing speech in a noisy environment
localising sound
remembering information or given instructions
making up and keeping rhythm
discriminating and recognising sounds
sequencing auditory information (from sequencing sounds to produce words, to retrieving automatic sequences such as recitation of numbers)
with phonological awareness tasks.
processing temporal patterns (such as, temporal integration, temporal discrimination, temporal ordering, and temporal masking)
processing information at adequate speed
integrating speech with movement (e.g.,walking and talking)
So, if you find yourself wondering why does my child:
have difficulty paying attention
have difficulty following oral instructions
battle to carry out multistep commands
have trouble with listening skills
have poor performance at school
have behaviour problems
have difficulty with reading, comprehension, spelling and vocabulary
Your child may be presenting with an auditory processing disorder.
Speech therapy for children with APD is tailored around targeting specific difficulties such as auditory memory tasks which improve the child’s ability to hear a multistep command, remember it and carry it out, language tasks such as enhancing vocabulary knowledge, skills to aid with spelling and reading difficulties and auditory discrimination tasks (hearing differences between sounds).
Autistic Spectrum Disorder (ASD) is an umbrella term that covers children with highly-varying abilities. Children with ASD can range from being very proficient in their language use (e.g., some children with Asperger’s syndrome) to being non-verbal. Intellectual abilities can also be very diverse. All children who are diagnosed with ASD are said to have a Triad of Impairments:
Social interaction
|
Communication
|
Imagination - Flexibility of Thought
|
One of the main concerns expressed by the parents of a child who has been diagnosed with Autism is: “Will my child be able to talk?” Extra help, encouragement and intervention are almost always required to set a child on the right path of communication and teach them what communication is indeed all about. Getting your child involved in a Speech Therapy programme as soon as possible is the first step to enhancing and encouraging more functional speech, language and communication development.
For children with ASD Speech Therapy focuses on:
- Language development (receptive and expressive)
- Social Communication
- Pragmatics, which also focuses on improving a child’s social–language skills
- Using language for different purposes (greeting, requesting, informing)
- Changing language style according to the listener and situation
- Ffollowing conversational rules (turn taking, introducing the topic, maintaining the topic and using facial expression appropriately)
- Use of Alternative and Augmentative means of Communication (AAC) where necessary (LINK to AAC)
Asperger’s syndrome (AS) is the highest-functioning form of Autism. Children with AS are also followed at ATLAS Training, using our unique Transdisciplinary team approach
A Hearing Impairment is the partial or total inability to physically hear, process and/or interpret sound. It can be of varying degrees and of different types. It can affect one or both ears. Hearing impairment can vary from mild to severe/profound, depending on the frequencies that are affected.
Hearing Impairment comes from different biological or medical causes. Most commonly, the ear (one or both) is the affected part of the body.
People with a hearing impairment are almost never ‘dumb’ (or mute). No matter what the degree of hearing loss all people with a hearing impairment have the ability to produce sound, especially if aided and taught. Certain sounds are more difficult to produce than others as they may not be as visible visually, e.g., /k/, /?/, /g/, /h/.
People with a hearing impairment are usually said to have a monotonous quality to their voice, due to their lack of intonation and/or pitch. They may also sometimes speak too loudly as they cannot monitor their own speaking volumes.
Communication for people with hearing impairments can be augmented and/or enhanced through:
Lip reading
Sign Language. This is usually the initial language that the child will be exposed to. It should be used as part of Total Communication: sign, verbal, written.
Hearing aids
Cochlear Implants
Speech Therapy at A.T.L.A.S. for children with a hearing impairment focuses on both Sign Language training as well as facilitation of spoken language. The choice as to whether to focus on sign language mastery or spoken language is a personal one, and should be made on an educated and sound understanding of the child’s hearing impairment. We endeavour to follow the child’s and parents’ wishes with regard to the mode of communication chosen and promote communication within this framework.
The Total Communication approach is generally advocated with children with a hearing loss. This targets the use of sign language, spoken language as well as the written medium as means of communication, i.e., all possible means for communication. Furthermore the child’s ability to use visual cues i.e., their speech reading/lip reading skills to understand language and follow instructions is also target
A phonological disorder is a group of language disorders which describes a child’s inability to a develop a mature speech sound system. Such a disorder can also affect the child’s ability to read and spell. A phonological disorder describes a child who has not learnt the rules for how sounds fit together and use processes to simplify words – making speech unintelligible.
To find out more read up about phonological awareness.
This is the awareness that words can be broken into smaller units; their constituent sounds, which are based on the phonological sounds of the language. Phonological awareness does not involve attaching any meaning to the particular sounds. Some phonological awareness skills are: sentence segmentation, syllable segmentation, rhyming phonemic blending, and grapheme-phoneme correspondence.
A number of children who have a history of a speech and language delay and later on phonological difficulties are most likely to be at risk of having reading and writing difficulties later on as well. The reason for this is that literacy and verbal communication are strongly related. This is not only because reading skills make use of phonological units, but also because understanding what you read, and writing about something involve the abilities to think about and use language creatively. Therefore, early intervention and/or continuing speech-language therapy are the best options for children with a history of speech and language problems. At A.T.L.A.S. Training the SLT works on all aspects of a reading and writing problem since we use literacy for a variety of functional purposes: from writing single words to writing a school essay; from reading a sign to reading a recipe, an ordinary book or a work memo. The SLT also works with the OT and teacher if necessary to help the child become an effective communicator, problem-solver, and decision-maker. These are some of the skills targeted during literacy therapy:
Working on and reinforcing phonological awareness skills,
Spelling
First stages in reading and writing simple to more complex words
Reading for content and comprehension
Reading and writing fluently and efficiently
Planning and sequencing what to write and what to write about, and most of al
Reading and writing for the pure pleasure of these skills
As a parent, you too can help and support your child on the path to literacy:
Provide plenty of opportunities for book reading and story telling
Have a variety of books with varied content available
Choose books with simple pictures which can be labelled and described in simple language
Talk about writing and its functions i.e., when writing a shopping list
Let your child see you reading and enjoying books
Communication is more than the words and sentences that we use; there is another domain of language: pragmatic or social language. This describes how we use language in different contexts.
Children with PLI will often have appropriate development of the language domains of grammar, vocabulary and phonology and will be verbally fluent. They have more specific difficulties with the social aspects of language:
Turn taking,
Eye contact,
Topic initiation, topic maintenance and topic termination
Typical word choices and usage
Flexible use of language (i.e., adjusting the language according to the listener and/or context).
Interpretation of figurative language
Appreciating the thoughts and feelings of others
PLI may be found in children with Specific Language Impairment, Learning Disabilities, Autistic Spectrum Disorder and Traumatic Brain Injuries.
This is a tendency to overreact to ordinary touch stimulation. Imagine the feeling you get when some-one scrapes their fingernails down a blackboard. This will give you an idea of the feeling a tactile defensive person gets when faced with a touch sensation that they can't tolerate. Now, imagine that this happens again and again. This can build up a huge amount of frustration and tension in a child and could be a possible cause for behavioural outbursts such as fighting in school, temper tantrums or crying.
This can be called the 'touch' system. The tactile system carries information from the skin to the brain. It tells us information such as temperature, texture, shape, location and intensity of touch. Integrating the tactile system means making sense of the information that is received from the tactile nerves. This means understanding how we are touched, where we are touched and with what intensity. It also means being able to identify objects by touch.
The vestibular system allows the body to understand its movement based on movements of the head. This is the system that helps you keep your balance, tells you whether the car is moving or standing still, and tells you which direction you are moving. Children who have a poorly integrated vestibular system are likely to have poor balance, appear clumsy, have poor eye movements (which are essential for reading) and may be gravitationally insecure. Some of these children may seek vestibular information, (by moving continuously or swinging very high or jumping off couches or walls). Others may avoid vestibular sensations (prefer not to do balance type activities, such as walking on curbs and be very anxious of heights, such as glass elevators or open stairs).
Visual Motor Integration is the ability to ‘link’ what the eyes see to what the body does. Any activity that requires us to look at what we are doing in order to achieve it, relies on visual-motor integration. This skill is an integral part of writing, but is also necessary for activities such as threading beads, building blocks, tying shoelaces, etc.
Visual perception is the ability to interpret or understand information received by the visual system (the eyes) and to recognize, recall and make sense of what we see.
Poor visual perception skills will impact on reading, writing and many everyday tasks such as doing puzzles, finding objects on a crowded desk, discriminating between similar objects etc.
Form Constancy: Recognizing a shape as the same shape regardless of its size or colour.
Colour Constancy: Recognizing a colour to be the same colour regardless of intensity or hue.
Figure Ground: The ability to identify a specific figure among a crowded background.
Position in Space: The orientation of object in space (i.e. is the object facing up or lying on its side) This is essential for identifying the difference between b & p etc.
Spatial Relations: Understanding the position of 2 or more objects in relationship to each other (i.e. is one on the right or above the other. Are they touching or slightly apart etc). This is important for reading, drawing, geometry, etc.
Visual Discrimination: Identifying detail/differences between items.
Visual Closure: Identifying an object even though not all of it is visible.
Visual Memory (& Visual Sequential memory): Recalling visual information
